Foot & Ankle Surgery: Techniques, Reports & Cases (Jan 2024)
Orthoplastic management of complex bone and soft tissue pathology with a fully radiolucent circular external fixation system
Abstract
Introduction: The typical circular external fixator possesses radiodense multi-level ring tibial blocks ad struts for stability, even in patients with intact osseous architecture. We analyzed the applications and outcomes of a fully radiolucent limited ring external fixation in the orthoplastic management of complex bone and soft tissue pathology. Methods: Consecutive patients were selected and followed, and data collected during the use of a fully radiolucent external fixation system in patients without large segment tibial bone loss. Basic patient demographics, risk factors, body mass index, the clinical indication, the use of external fixator, and time in external fixation were analyzed. All patients underwent early mobilization with full weight bearing with an assistive device. Any untoward external fixator complication and outcome was recorded. Institutional Review Board approval was obtained. Results: There were nine patients with a mean age of 44 (range = 22–73) with a mean follow-up of 17 months (range-6–26 months). Fifty-six percent were enrolled in the study who all received a two-ring radiolucent external fixation device. All patients had risks for external fixation complications with 89 % possessing multiple risk factors. Four patients (44 %) had neuropathy from the mid tibia to the foot. Bone stabilization was performed for 67 %, soft tissue offloading/limb stabilization for 55 %, a combination of bone and soft tissue stabilization for 33 % of patients. Conclusion: Lightweight radiolucent circular external fixation of the lower extremity in patients without intercalary bone loss can provide satisfactory stability and allow early mobilization with minimal component complications. The added advantage of having radiolucent rings and struts allows for better visualization of osseous structures such as fractures care and fusions. The ability to manipulate foot position required for a particular bone/soft tissue reconstruction is also possible.
